腹腔间隙综合征患者腹内压与肾功能变化的相关性研究

Study on the correlation between the changes of intra-abdominal pressure for patients with abdominal cavity interspace syndrome and renal functional

目的观察腹腔压力增高对肾功能的影响。方法对60例腹腔间隙综合征患者,每日三次在固定时间检测患者腹腔压力,记录平均动脉压、中心静脉压,同时留取血液标本检测血清肌酐,记录每小时尿量。结果随着腹腔压力升高,尿量逐渐减少,由92.6±20 ml/h降至27.9±11.7 ml/h(P<0.05),同时血清肌酐由68.4±39.3mmol/L升至249.4±111.5 mmol/L(P<0.05),伴随中心静脉压(由1.34±0.25 kPa至2.12±0.22 kPaP<0.05),升高和平均动脉压升高或下降,腹腔压力的上升与尿量呈负相关(r=-0.193,P<0.05);与血清肌酐呈正相关(r=0.162,P<0.05),但与平均动脉压无相关性。结论腹腔压力的上升与少尿、血清肌酐上升密切相关;液体复苏、利尿剂的应用,对肾功能恢复效果不明显,而降低腹腔压力后,尿量增多、血清肌酐下降。

Objective To study the effect of renal function due to increase of intra-abdominal pressure. Method 60 patients with abdominal cavity interspace syndrome were selected. Intra-abdominal pressure, average arterial pressure, central vein pressure were measured thrice per day, blood sample was collected for serum ereatinine measuring, urine volume per hour was recorded. Result As the intra-abdominal pressure increased, the urine volume was decreased gradually. From 92. 6 ± 20 ml/h to 27.9 ± 20 ml/h （P〈0.05）. Serum creatinine was increased from 68.4±39.9 mol/L to 249.4±111.5mol/L（P〈0.05） as the increase of central vein pressure（ from 0.98±0.19 kPa to 1.56±0.31 kPa） and average artery pressure increase or decrease, This increase of intra-abdominal pressure was negatively correlated with the urine volume（ r=-0. 193, P〈0.05）, and positively correlated with serum creatinine （r=0. 162, P〈0. 05）, no correlation with average artery pressure. Conclusion The increase of intra abdominal pressure were correlated with oliguria and serum creratinine increase. Solution anabiosis and applying diuretic will be less-effect in renal function recovery. Reduce intra abdominal pressure will increase urine volume and reduce serum creatinine.